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Reversal of Combination Nondepolarized Neuromuscular Block

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Abstract

The antagonism of a pancuronium-curare (P + C) neuromuscular block was assessed and compared to the antagonism of a pancuronium (P) block. One group of seven patients received P + C (0.024 mg/kg + 0.144 mg/kg); another similar group of seven patients received P (0.07 mg/kg). Both groups were anesthetized with nitrous oxide/ oxygen/narcotic anesthesia. Each patient received 0.025 mg/kg of neostigmine when a train-of-four revealed only one twitch (90% block). The resultant antagonism of the pancuronium-curare blocks was the same as the antagonism of the pancuronium blocks (train-of-four ratio, 0.38 vs 0.32; P = 0.5). The authors conclude that neostigmine requirements for combination blocks are the same as those for single agent blocks.

Key Words: ANTAGONIST • Neuromuscular relaxants: neostigmine • NEUROMUSCULAR RELAXANTS: pancuronium, d-tubocurarine.

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999